KORELASI KADAR SERUM TISSUE INHIBITOR of METALLOPROTEINASES-1 (TIMP-1)DENGAN SKOR CHILD PUGH PADA PASIEN SIROSIS HATI

R.MAULANA RAHMAT YUDISTIRA, dr. Siti Muchayat P. MS. Sp.PK (K).; Dr. Dra. Sri Herwiyanti, MS.

2016 | Skripsi | S1 PENDIDIKAN DOKTER

Sirosis hati adalah merupakan penyakit fibrosis hati oleh berbagai etiologi antara lain infeksi virus, parasit, alkoholisme, penyakit metabolic, autoimun dan drug induce / toxicity, dimana pasien mempunyai resiko kompilasi klinik berupa hipertensi portal, disfungsi hepatoseluler, dan keganasan hepatoseluler. Penelitian saat ini, untuk menilai progresifitas kemunduran fungsi hati pada sirosis hati ditujukan pada marker non invasif dan direk pada matrix extrasellular diantaranya tissue inhibitor of metalloproteinase-1 (TIMP-1). Tingkat Keparahan sirosis hati dalam klinis dilakukan dengan menggunakan skor Child-Pugh yang tidak terlepas dari subyektivitas dan inkonsistensi. Penelitian ini bertujuan menguji korelasi antara kadar serum tissue inhibitor of metalloproteinase-1 (TIMP-1) dengan skor ChildPugh. Penelitian ini menggunakan rancangan potong lintang terhadap pasien sirosis hati yang diambil secara berurutan di bangsal Penyakit Dalam dan pasien sirosis hati rawat jalan di poli Hepatogastro-Enterologi RS DR Sardjito Yogyakarta. Terhadap pasien dilakukan anamnesis, pemeriksaan fisik, dan pemeriksaan laboratorium. Analisis statistik dilakukan dengan menggunakan rerata, simpang baku dan proporsi untuk statistik deskriptif, Mann-Whitney untuk beda rerata lebih dari dua kelompok. Besar sampel yang dipergunakan sebanyak 59 subjek, untuk mengetahui korelasi antara kadar serum tissue inhibitor of metalloproteinase-1 (TIMP-1)dengan skor Child Pugh digunakan Spearman correlation untuk uji korelasi. Hasil penelitian ini didapatkan adanya perbedaan yang signifikan pada rerata TIMP-1, antara: Child-Pugh A dengan Child-Pugh B, Child-Pugh B Child-Pugh C, dan Child-Pugh A dengan Child-Pugh C (p 0,000). Hasil penelitian ini didapatkan marker TIMP-1 berkorelasi kuat dan signifikan dengan skor Child-Pugh (r 0,882 p 0,00). Simpulan penelitian ini terdapat korelasi antara TIMP-1 dengan skor Child Pugh pada penderita sirosis hati.

Liver cirrhosis is a disease of liver fibrosis by various etiologies include viral infections, parasites, alcoholism, metabolic diseases, autoimmune and drug induced / toxicity, in which patients are at risk in the form of portal hypertension clinic compilation, hepatocellular dysfunction, and hepatocellular malignancy. The current study, to assess the progression of deterioration of liver function in liver cirrhosis is aimed at non-invasive marker and direk on extrasellular matrix tissue inhibitor of metalloproteinase such-1 (TIMP1). Severity of liver cirrhosis in clinical performed using the Child-Pugh score were not independent of subjectivity and inconsistency. This study aims to examine the correlation between serum levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) with Child-Pugh score. This study used a cross-sectional design of the patients with liver cirrhosis were taken sequentially in Internal Medicine wards and outpatient patients with liver cirrhosis in polyEnterologi Hepatogastro RS DR Sardjito. Currently treated by history, physical examination, and laboratory tests. Statistical analysis was performed using the mean, standard deviations and proportions for descriptive statistics, Mann-Whitney test for mean difference of more than two groups. Used a large sample of 59 subjects, to determine the correlation between serum levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) with Child Pugh score used the Spearman correlation for correlation test. The results of this study found a significant difference in the mean TIMP-1, between: Child-Pugh A and Child-Pugh B, Child-Pugh B and Child-Pugh C, and Child-Pugh A and Child-Pugh C (p 0.000). Marker TIMP-1 significantly correlated with Child-Pugh score (r 0.882 p 0.00). Conclusions This study found a correlation between TIMP-1 with Child Pugh score in patients with liver cirrhosis.

Kata Kunci : Liver Cirrhosis, Severity, Child-Pugh score, Tissue Inhibitor of Metalloproteinase-1 (TIMP-1)